A physician goes from stressed to zen

I did not need help. I could do it myself. I never asked, and anyone who worked with me quickly understood they did not need to offer.

This was my modus operandi. It was how I unconsciously organized my life, no more aware than riding a bike or tying my shoes. It happened in the background — utterly unknown to me for many, many years.

I could see “side effects” of this unconscious pattern, the importance of self-sufficiency and doing everything on my own. I relished the ability to do what others were doing and then do just a little more. This brought me a sense of pride and a sense of satisfaction. I enjoyed the monthly business meeting. The numbers would flash on the screen, once again I was in the top two places for gross revenue generated. It felt good — really good — to see my value. And when they asked for a little more, I gave it to them. It was also important for me to give help to others: stepping forward to take on extra committee duties, switching call to accommodate. It felt good, honorable and useful. So, I felt all of this in the process of helping.

Underneath, resentment simmered. It would show up in small subtle ways I often ignored or more significant ways that I did not recognize. I would be thinking “no one says thank you for all I do.” I would ruminate about doing more than others, brewing an unpleasant stew of resentment that would come out in relationships as displaced anger. It would find a path out; the littlest crack allowed an episode of venting. Small things irritated me. I would react — cracks appeared. Pressure, built up from other parts of my life, would find a way out in anger. Those I cared about most were the inadvertent targets. Remorse, guilt and self-loathing would follow the venting, and I would double down on the containment system to prevent it from happening again.

It sounds clear in hindsight. Looking back, I am surprised I did not put it together more quickly. But as I said, I did not ask for help. I stumbled along frustrated, adding to my plate full of duties, slowly burning internally. Whether I changed jobs or changed countries — it was there. Walking away to a new place would empty the system temporarily. But, slowly, pressure would once again build as I noticed feeling overwhelmed, taking on too much, being overstretched. I meditated, read books on burnout, looked to see exactly how my 168 hours each week was spent. I began asking the question: “Does this make me happy?” I withdrew from committees when my term expired, I declined opportunities to join committees, and I studied my daily spread of time with an intense curiosity, slicing away anything that did not serve me.

As I began cutting back, I noticed unpleasant feelings, feelings that I was a slacker, lazy, not doing my part. I ignored these feelings, convinced what I was doing was in my best interest. But it did not relieve the underlying distress that arose from this action.

Fortunately, I enrolled in an introduction to Hakomi Somatic psychotherapy where I learned about the ways everyone responds to stresses in their early life, and I begin to get curious.

I started studying my reactions, listening to words that would arise in my head when I set a limit or a boundary. I began to ask if they were my words or words I had learned from others. Slowly, it began to dawn — how much of my life had been influenced by the “value of work” that was ever-present in my home.

I had internalized a strong work ethic in my early years. It manifested as being helpful, being self-sufficient. Among my classmates, I began to explore the origins of my need to be helpful.

You see, it had arrived in the training — like a little friend who could not be left behind. I found myself coming early to help set up the room. I felt my resentment as others did not acknowledge my help in ways I could take in. In this training, we study whatever arises in the moment, and so I began to study this pattern of behavior closely.

I noticed how my body participated in the behavior. My jaw would tighten with the first blushings of irritation; I would slow things down, really study how it felt, dive into the experience. Fragmentary memories would arise of how I came to establish this behavior and the pain that I sought to avoid through these actions. I came to see I learned self-sufficiency when my parents were overwhelmed by my brother and his medical needs. I could see how life had gone from being the center of attention to being further down that chain, as his needs outstripped mine. I decided to take care of myself, so I would not have to feel the pain of neglect. I learned that being helpful got me noticed in a positive way, so I jumped in full force being helpful at every opportunity. It makes so much sense, being self-sufficient meant I would not be neglected, being helpful meant that I would be noticed and praised. It is from this fertile ground that my behavior arose, it was groomed and shaped by the events of my later life, but this had been the soil from which I grew.

Knowing where a thing comes from, you can see it from many different angles, notice how it plays out, and see the little interconnections arising from this modest beginning. When you land upon this knowledge in a moment of deep mindfulness, you have the opportunity to change how you feel about it, opening many pathways and possibilities. While I still default toward helpful self-sufficiency, I am experimenting with asking for help, noticing the little flutter in my heart as I step out and do something new, different and brave. Little steps, changing the behavior a little more, opening a little more freedom in my world to truly be all that I am meant to be.

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